1978, 05-23 Permit App: M6409 Residence, Renewal of M09200
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of any
kind or alter any building or structure already erected, or to change a land use. Construction must conform with the
Spokane County Building Code and Zoning Ordinance. Construction is subject to inspection.
WATER. Water supply must be approved by the County and State Health Departments. Where work onvater connections disturbs
the surface, shoulders or ditches of County Roads, permission must be obtained from the County Engineer's Office.
SEWAGE SYSTEM. Permits are required in all cases by County Resolutions Nos. 45-133 and 47.235.
SET -BACK FROM PROPERTY LINES. In most zones and under most circumstances, a set -back from the front property line, of at
least 25' is required, a 5' side yard, 15' side yard from a flanking street, and a 25' rear yard are required.
STATE HIGHWAYS. Where the structure abuts a State Highway, clearance must be obtained pertaining to set -back and ingress
and egress.
COUNTY ROADS. Work on street right-of-way may not be performed until staked by County Road Department and work must be
performed in accordance with stakes. Points of ingress and egress must be approved by the County Engineer.
MOVING OF BUILDINGS. A permit is required to move an existing building. When a building is moved on a County or State
Highway, clearance must be obtained from the County Engineer and/or State Highway Department.
ACCESSORY BUILDINGS. Accessory buildings (garages,' sheds, etc.) require a separate permit.
RESTRICTIVE COVENANTS. Builders should check provisions of covenants or dedications and easements running •ith the land
which are enforceable through civil action. County Officials can not bring action to enforce covenants or dedications.
,it/��,/) [yyPPL�L CANT FILL IN BELOW THI LI/�/ C �1�p / / -y
Name of Owner It ./�jt'U%%����/ 1 • 7SAddress Address 11� /- i/.� Phone C1-24
1- 4l / 772
Architect Address Phone
Engineer /' Address - Phone
Contractor .I/1761 Address
Legal Description of Property (Give complete description from deed, tax receipt. etc.) Parcel Num
.Cot
ROADWAY /W WIDTH
DESCRIPTION OF WORK: New Addition
t'/l- -reaciYfr}.. 7,eit
/
Remodel Moving Bldg.
Want Lot /c'X_ '/ty �` �. RC1 ��2 / x / Sewage System
Stories / Dimensions
Rooms `i" Bath % Basem. • -.'� Foundation Const
(F II part,
Heat. SystemE Type' o f Roofing
Use of Bldg.
Fire e
FFor n. r., Conc., Br., etc.)
tal Sq Ft /2 2 Valuation //
Chimney Fireplace//- r`2 •
(Numb
..ULc-jJnt Wall Finish
No of Units _Bedr s
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location of existing and
proposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
NORTH
SOUTH
State License No.
Ind. Ins. Acct. No.
RESIDENTIAL — COMMERCIAL
REQUIRED
Plumbing Permit
m Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby ccertifyeiiinfg[�atio submitted is correct and there are no other structures 1
Owner or Agent
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE
THIS IS NOT A PERMI
as, t own.
oN NN ,^Q pl 00NOT WRITE BB OW THIS LINE
Tour street address will be 3 A/L- //.tl/i ,.��/ The zone is
Sewage Permit Number Issued Building :�rmit 7,76,VOIReceip t Issued
Remarks
sAw.s� 'i .8'
ted on this pt'bperty except
Date
CONSTRUCTION COMMENCES.
Form 523 Bldg. Code